Are children overdiagnosed with attention deficit disorder?

Yes

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by Jonnie Chastain

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ADD AND ADHD

"Attention-Deficit/H yperactivity Disorder (ADHD) is generally considered to be a developmental disorder, largely neurological in nature, affecting about 5% of the world's population. The disorder typically presents itself during childhood, and is characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness, poor impulse control or impulsivity, and distractibility. Although often referred to in conjunction with Attention Deficit Disorder (ADD), ADD is, in fact, not a documented diagnosis, and this common misuse of the terminology actually refers to ADHD predominantly inattentive type." (Wikipedia)

Perhaps teachers and doctors who are so quick to suggest and diagnose ADHD are themselves suffering from attention deficit'. It could be that if they paid more attention' to the individual child and concentrated on the possible deficit' in the classroom, or in the practice of over-medicating', they would better serve our children.

I realize that there are many genuine cases of ADHD and those who are truly suffering from this disorder can often benefit from medication. But let's get real. The following statistics appear to indicate that we are medicating unruly children just to make it easier for parents and teachers.

The following is a Press Release from BOSTON LIFE SCIENCES INC. dated December 17th, 1999.
"ADHD is the most commonly diagnosed behavioral disorder in children and is the fastest growing psychiatric disorder in adults. Since 1990, the total number of American children diagnosed with ADHD has risen from 900,000 to over 5.5 million, and the use of stimulant medication such as Ritalin" has increased 700% in the same period" Adders.org-Research (There is something seriously wrong with this picture.)

I raised four children and you might say I had two families. My two oldest are three years apart and seven years later I gave birth to two more that are three years apart. I am speaking of the time span of May 1955 to October 1967. The seven years between the two sets made all the difference in the world in their experiences at school.

The older two (a boy and a girl) were, for the most part, normal well-behaved children who had no problems to speak of in school. If they came home complaining about a teacher they quickly learned that my sympathy was with the teacher. The two youngest (a girl and a boy) were also, for the most part, normal well-behaved children but they had more problems during their school years. I soon learned that when they came home upset about a teacher their complaints were, as often as not, legitimate. At no time did a teacher ever suggest that any one of my children needed to be medicated.

However, when my one and only grand child started Kindergarten in 1998 it wasn't long before her teacher was suggesting that medication might be called for. We flatly refused to consider it. We knew that her problem was boredom.

While most of the other children in her class were content with what they were being taught, she and a few others had already been taught those things before starting school and they needed new challenges to hold their attention. It wasn't the teacher's fault, she needed to have order in her classroom, it wasn't our fault, for having taught the child well, and it most certainly was not the fault of the child. Once she was in the first grade there was no more problem. Why should she or any others like her be medicated for what is essentially a problem with the school system?

I fear that a diagnosis of ADHD has become the easy way out. How many of those now being medicated have actually been diagnosed according to the following criteria?

DIAGNOSING ADHD
By MARY FOWLER

Unfortunately, no simple test, such as a blood tests or urinalysis exists to determine if a child has this disorder. Diagnosing ADHD is complicated and much like putting together a puzzle. An accurate diagnosis requires an assessment conducted by a well-trained professional (usually a developmental pediatrician, child psychologist, child psychiatrist, or pediatric neurologist) who knows a lot about ADHD and all other disorders that can have symptoms similar to those found in ADHD. Until the practitioner has collected and evaluated all the necessary information, he or she must follow the same rule of thumb as the parent or teacher who sees the behavior and suspects that the child has the disorder. Assume the child might have ADHD.

THE EVALUATION

ADHD diagnosis is made on the basis of observable behavioral symptoms in multiple settings. This means that the person doing the evaluation must use multiple sources to collect the information needed. A proper ADHD diagnostic evaluation includes the following elements:
1. A thorough medical and family history;
2. A physical examination;
3. Interviews with the parents, the child, and the child's teacher(s);
4. Behavior rating scales completed by parents and teacher(s);
5. Observation of the child;
6. A variety of psychological tests to measure I.Q. and social and emotional adjustment, as well as to indicate the presence of specific learning disabilities.
It is important to realize that, almost characteristically, children with ADHD often behave well in new situations, particularly in those that are one-on-one. Therefore, a well-trained diagnostician knows not to make a determination based solely on how the child behaves during their time together.
Sophisticated medical tests such as EEGs (to measure the brain's electrical activity) or MRIs (an X-ray of the brain's anatomy) are not part of the routine assessment. Such tests are usually given only when the diagnostician suspects another problem, and those cases are infrequent. Similarly, positron emission tomography (PET Scan) has recently been used for research purposes but is not part of the diagnostic evaluation.

After the Evaluation
After completing an evaluation, the diagnostician makes one of three determinations:
1. The child has ADHD;
2. The child does not have ADHD but his or her difficulties are the result of another disorder or other factors; or
3. The child has ADHD and another disorder (called a coexisting condition).
To make the first determination - that the child has ADHD - the professional considers his or her findings in relation to the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders (4th edition), the DSM-IV, of the American Psychiatric Association (1994). A very important criterion for diagnosis is that the child's symptoms be present prior to age seven. They must also be inappropriate for the child's age and cause clinically significant impairment in social and academic functioning.

To make the second determination - that the child's difficulties are the result of another disorder or other factors - the professional considers the exclusionary criteria found in the DSM-IV and his or her knowledge of disorders with similar symptoms. According to the DSM-IV, "Attention-Deficit/H yperactivity Disorder is not diagnosed if the symptoms are better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, Personality Disorder, Personality Change Due to a General Medical Condition, or a Substance-Related Disorder). In all these disorders, the symptoms of inattention typically have an onset after age seven years, and the childhood history of school adjustment generally is not characterized by disruptive behavior or teacher complaints concerning inattentive, hyperactive, or impulsive behavior" (American Psychiatric Association, 1994, p. 83).
Furthermore, psychosocial stressors, such as parental divorce, child abuse, death of a loved one, environmental disruption (such as change in residence or school), or disasters can result in temporary symptoms of inattention, impulsivety, and overactivity. Under these circumstances, symptoms generally arise suddenly and, therefore, would have no long-term history. Of course, a child can have ADHD and also experience psychosocial stress, so such events do not automatically rule out the existence of ADHD.

To make the third determination - that the child has ADHD and a co-existing condition - the assessor must first be aware that ADHD can and often does coexist with other difficulties, particularly learning disabilities, oppositional defiant disorder, and conduct disorder. All factors must be considered to ensure the child's difficulties are evaluated and managed comprehensively. (National Information Center for Children and Youth with Disabilities (NICHCY) Briefing Paper, Revised Edition, October 1994. Contact NICHCY at P.O. Box 1492, Washington, DC)

SIDE EFFECTS OF ADHD MEDICATIONS

Stimulant medications are often prescribed for the treatment of symptoms of ADHD. The most common are: methylphenidate (Ritalin, Concerta), dextroamphetamine (Adderall, Dexedrine). These medications have many side effects in common. Some of the side effects that can appear for the first few weeks of taking medication and do not necessarily require you to contact your physician include:
Loss of appetite
Headache
Stomach upset or nausea
Weight Loss
Problems Sleeping
If any of these side effects last for more than a few weeks, you should contact your physician.
In addition, according to the patient inserts provided with your medication, there are a number of side effects from stimulant medication that you should discuss with your physician immediately:
Anxiety, nervousness and mood changes
Chest pain, irregular or fast heartbeat
Increased blood pressure
Joint pain
Skin rash
Uncontrollable tics
Fever
In addition, Ritalin and Concerta can also cause bruising.

FINDING NATURAL ALTERNATIVES ADHD CHILDREN CAN USE
by Sue Perkins

Most doctors, when they encounter a case of ADHD, turn to stimulant or anti-depressant drugs to counteract most of the disorders symptoms. However, in taking these drugs the effects are short lived and the medication needs to be constant. There is also the possibility of various side effects to contend with too. Because of this, it is only natural that parents try to find alternatives. Most parents are attracted by natural alternatives ADHD children can take as opposed to prescribed drugs mainly because they are considered to have less side effects. Here are some natural alternatives for ADHD that have shown promise:

1) Caffeine Caffeine is a stimulant, just like the prescription drugs are. This means that caffeine perks up a person who is feeling a bit drowsy. It is ironic that stimulants seem to have a reverse effect on people with ADHD. People who have used caffeine as a natural alternative to ADHD report being able to calm down and think clearly and yet have no trouble with hyperactivity.

Caffeine is found in coffee, tea, soda and some chewing gum. However, with everything moderation is key. Children should be okay to have 2.5mg of caffeine for every kilo they weigh a day. Just like stimulant drugs, this treatment is not for everyone and be aware of the sugars and other ingredients in soda that can have detrimental effects on health.

2) DMAE This is a compound that occurs naturally in the body and in some fish. Making use of DMAE as a natural alternative or complement to ADHD prescription medicines has been shown to be effective. Studies carried out in the 1970's looking at the effects of DMAE on people with ADHD showed results that where comparable to taking Ritalin. You will find DMAE supplements available, however there is a risk of some side effects, notably headaches, insomnia, depression, irritability and restlessness. So it pays to be careful with dosages.

3) Essential Fatty Acids These are also found in fish and some plants. Essential fatty acids have been linked with improved mental capability and even cardiac health. Essential fatty acids can be obtained by eating deep-sea fish regularly. However, you should be careful because deep-sea fish can also have high levels of mercury in their meat. An option you can consider is cod liver oil and other fish oil supplements, although be sure the source of the fish is stated and that its mercury free. Fish oils have long been marketed as a great supplement for improving focus before people thought of using it as a natural alternative to ADHD medication.

4) B vitamins Research shows that treatment with the B-group vitamins, especially Vitamin B6 & B12, helps a child with ADHD remain focused. There are a lot of food sources of this vitamin. However, you should keep in mind that you may not get enough of these vitamins from food alone and so taking a B-complex supplement can help.

The natural alternatives ADHD sufferers can take can make a difference to ADHD behaviors. However, it may take some experimentation to find the ones that are most suitable. Discussing these options with your doctor is essential before starting on any new regime and never stop taking prescription medication without first seeking medical approval.

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Let's do the right thing for our children. Let's stop taking the easy way out. Inattentive or fidgety behavior is not always ADHD and medication is not always the answer.

(Research materials were obtained from goodsearch.com)

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